Reason Code 32243

Published 12/16/2019

Description
A home health billing transaction (Request for Anticipated Payment, final claim or adjustment) was submitted without a 0023 revenue code line or a revenue code line for a visit was billed without charges.

Resolution
Ensure that all billing transactions submitted for services paid under the Home Health Prospective Payment System (HH PPS) include a 0023 revenue code line. See the screen print of FISS Page 02 below. A revenue code 0003 was entered on line 1 instead of a revenue code 0023.

Ensure that charges are entered for all revenue code lines reporting supplies or a visit. In the example of FISS Page 02 below, revenue code lines 6, 7 and 8 were billed without charges, resulting in the claim being returned with reason code 32243.

Reminder: You may need to press the F5 and F6 keys when reviewing revenue code information on FISS Page 02 in order to determine which line item dates of service are missing charges.


Was this article helpful?